Table 3.

Main findings of the study

China

Malaysia

Policy setting China lacks a cohesive national healthcare policy for international migrant workers, however Yunnan province, a major border province, has several programmes for the management of cross-border migrants. Maternal and child health services Safe motherhood packages are provided for migrant women and foreign spouses with legal documents Rigid administrative requirements including requirements for antenatal records at the facility are a barrier to hospital delivery Infectious diseases and migrant workers In addition to mandatory medical screenings by the immigration office, targeted infectious disease surveillance of non-citizens is common Excessive attention on infectious disease control programmes targeted at migrant workers has resulted in stigmatisation Language barriers and the lack of cultural sensitivity may have exacerbated migrants’ distrust of healthcare providers Free anti-retroviral treatment is provided conditionally to HIV infected non-citizens; however, these policies were designed to discourage cross-border travel specifically for HIV treatment Financial and language barriers to healthcare Medical treatment is unaffordable to migrant workers, since they are not covered by the Chinese health insurance Migrants face difficulties in communicating and navigating the healthcare system and often bring informal interpreters to accompany them to hospital

Policy setting Malaysia has several national healthcare policies for documented migrant workers including predeparture, pre-employment and annual medical examinations, and a government-mandated insurance scheme Maternal and child health services Migrant workers found pregnant are subject to termination from employment and deportation Pregnant migrant workers tend to avoid healthcare due to financial barriers and immigration restrictions, possibly resulting in poor obstetric outcomes Infectious diseases and migrant workers Migrant workers are obliged to undergo mandatory infectious disease screenings several times as an immigration requirement Migrant workers failing medical examinations are denied work permits and are subject to deportation. Failing medical examinations is a possible reason for ‘undocumented’ status. Concerns were raised on the quality of informed consent for HIV testing, proper explanation and confidentiality of infectious disease test results Financial and language barriers to healthcare SPIKPA insurance is inadequate in compensating the high fees charged to non-citizens at public hospitals, and does not cover outpatient care As there are no interpreter service in the healthcare system, the common expectation is for migrant workers to learn the Malay language or to bring a companion to act as an informal interpreter Health in detention Undocumented workers are sent to immigration detention centres, often for lengthy periods, to await deportation Conditions at immigration detention camps have been described as overcrowded, with limited available healthcare facilities

SPIKPA, Hospitalisation and Surgical Scheme for Foreign Workers.